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Practice Emotional PPE
We have personal protective equipment (PPE) for our body–but what about our mind? Huntsman Cancer Institute nurse manager Cassidy Kotobalavu has lead training on the concept of emotional contagion–how good (and bad) emotions spread. Here are Cassidy’s expert tips (with slides) on managing emotional contagion in health care.

What is emotional contagion?


motions and moods are transferred among people in a group. That means one person’s emotions and behaviors can trigger similar emotions and behaviors in other people. You can “catch” emotions the same way you would an office cold.

We are all susceptible to emotional contagion, no matter what work environment we’re in. Most emotional communication is transmitted through non-verbal behavior and facial expressions. These reflect and influence our internal feelings.

Why is negative emotional contagion so dangerous?

Negative emotions can have significant, long-lasting effects on our health and wellbeing. They include muscle tension, fatigue, low energy, insomnia, depression, second-hand stress, and an increased risk of asthma, diabetes, and heart disease.

In health care, we’re particularly vulnerable to negativity. It can disrupt us, clutter our minds, and prevent us from thinking clearly. When patients’ lives are in our hands, it’s critical that we’re careful about what germs—physical and emotional—we’re spreading.

Harness the power of positivity

Emotional contagion also affects us in a positive way. We got into health care because we wanted to help others. We’re a people-focused organization that exists to take care of patients. We’re innately compassionate people. Our ability to create connections is one of our greatest strengths.

Research by UCSD’s James Fowler and Harvard’s Nicholas Christakis found that happiness can have a ripple effect by three degrees: if you’re happy, you increase the chance of happiness in a close friend by 25%. A friend of your close friend enjoys a 10% increased chance of happiness, and that friend’s friend then has a higher chance of experiencing happiness. Networks matter.

Additionally, Fowler and Christakis found that the power of positivity outweighs the power of negativity. Each additional happy friend increases your chance of happiness while every additional unhappy friend drags your chances of happiness down. We have the opportunity to influence people in a positive way.

Think of PPE to protect from emotional contagion

Health care providers are really good at putting on PPE (personal protective equipment) to stay safe from physical contagions. If we have a patient that has the flu, we have a procedure to follow to protect ourselves. We’re not so good at protecting ourselves from negative emotional contagion—and it can be just as toxic for the workplace. So how can we protect ourselves?


Emotional Contagion Translation
Gown Pay attention to your body language as you communicate your emotions. Non-verbal behaviors account for most of the emotional communication that is retained by others.
Gloves Re-evaluate your electronic communication before hitting send. Feel out the situation before acting. Consider writing a “stop doing” list.
Mask Avoid gossiping. Stop and think before you speak by taking a deep breath—especially when giving and receiving feedback.
Booties Remove yourself from an emotionally-toxic situation without spreading it. Trace your emotion to the original source, then practice self-care.
Goggles When providing feedback, make direct eye contact, and don’t lose sight of the bigger picture. Recognize what type of emotion you’re focusing on, positive or negative.

This message is the same for a new nurse or a nurse who’s been here for 20 years. Emotional contagion doesn’t discriminate. The difference in the impact is your degree of personal resiliency. The more you can protect yourself, the better you’ll be able to deal with negative emotional contagion and promote positivity.

The Cut’s “Antidote for Emotional Contagion”

  1. Distract yourself. Train your attention away from a negative colleague.
  2. Launch a counter-attack. Exude serenity to affect your colleague’s moods.
  3. Talk to the person. Explain how your colleague’s bad attitude may be affecting others.

Want to have a discussion with your team?

Here are some slides to help. Ask your team: What strategies have worked for you in the past?

Originally published October 2018.


Cassidy Kotobalavu

Nurse Manager, Huntsman Cancer Institute, University of Utah Health

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